GI NCLEX EXAM 2 ASSESSMENT QUIZ WITH VERIFIED SOLUTIONS 2023-2024, Exams of Nursing

Download GI NCLEX EXAM 2 ASSESSMENT QUIZ WITH VERIFIED SOLUTIONS 2023-2024 and more Exams Nursing in PDF only on Docsity! GI NCLEX EXAM 2 ASSESSMENT QUIZ WITH VERIFIED SOLUTIONS 2023-2024 The most important pathophysiologic factor contributing to the formation of esophageal varices is: 1. Decreased albumin formation by the liver 2. Increased central venous pressure 3. Portal hypertension **** 4. Decreased prothrombin formation A client with peptic ulcer disease tells the nurse that he has black stools, which he has not reported to his physician. Based on this information, which nursing diagnosis would be appropriate for this client? 1. Ineffective coping related to fear of diagnosis of chronic illness 2. Imbalanced nutrition: Less than body requirements due to gastric bleeding 3. Deficient knowledge related to unfamiliarity with significant signs and symptoms **** 4. Constipation related to decreased gastric motility The client with a duodenal ulcer may exhibit which of the following findings on assessment? 1. Melena **** 2. Hematemesis 3. Malnourishment 4. Pain with eating A client has been taking aluminum hydroxide 30 mL six times per day at home to treat his peptic ulcer. He tells the nurse that he has been unable to have a bowel movement for 3 days. Based on this information, the nurse would determine that which of the following is the most likely cause of the client’s constipation? 1. The client has developed a gastrointestinal obstruction 2. The client is experiencing a side effect of the aluminum hydroxide. **** 3. The client needs to increase his daily exercise 4. The client has not been including enough fiber in his diet Which of the following measures should the nurse focus on for the client with esophageal varices? 1. Recognizing hemorrhage **** 2. Controlling blood pressure 3. Teaching the client about varices 4. Encouraging nutritional intake The nurse is caring for a client who has had a gastroscopy. Which of the following symptoms may indicate that the client is developing a complication related to the procedure? Select all that apply. 1. The client complains of epigastric pain **** 2. The client experiences hematemesis **** 3. The client appears drowsy following the procedure 4. The client complains of a sore throat 5. The client has a temperature of 100*F **** When a client has peptic ulcer disease, the nurse would expect a priority intervention to be: 1. Assisting in inserting a Miller-Abbott tube 2. Inserting an I.V. 3. Assisting in inserting an arterial pressure line 4. Inserting a nasogastric tube **** A client being treated for chronic cholecystitis should be given which of the following instructions? 1. Avoid antacids 2. Increase rest 3. Increase protein in diet The nurse is providing discharge instructions to a client following gastrectomy. Which measure will the nurse instruct the client to follow to assist in preventing dumping syndrome? ✖ 1. Sit in a high-Fowlers position during meals 2. Eat high-carbohydrate foods 3. Ambulate following a meal 4. Limit the fluids taken with meals **** Which of the following would be an expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer? ✖ 1. Regain weight loss within 1 month after surgery 2. Achieve optimal nutritional status through oral or parenteral feedings **** 3. Resume normal dietary intake of three meals per day 4. Control nausea and vomiting through regular use of antiemetics Which of the following dietary measures would be useful in preventing esophageal reflux? ✖ 1. Increasing fluid intake 2. Eating small, frequent meals **** 3. Adding a bedtime snack to the dietary plan 4. Avoiding air swallowing with meals A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine), antacids, and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to: 1. Inhibit the production of hydrochloric acid (HCl) 2. Inhibit vagus nerve stimulation 3. Reduce gastric acid output **** 4. Protect the ulcer surface The nurse is caring for a client following a Billroth II procedure. On review of the post-operative orders, which of the following, if prescribed, would the nurse question and verify? 1. Leg exercises 2. Irrigating the nasogastric tube **** 3. Early ambulation 4. Coughing a deep breathing exercises A client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergo a subtotal gastrectomy (Billroth II procedure). During pre- operative teaching, the nurse is reinforcing information about the procedure. Which of the following explanations is most accurate? 1. The procedure will result in anastomosis of the gastric stump to the jejunum **** 2. The procedure will result in removal of the duodenum 3. The procedure will result in enlargement of the pyloric sphincter 4. The procedure will result in repositioning of the vagus nerve Mucosal barrier fortifiers are used in peptic ulcer disease management for which of the following indications? 1. To stimulate mucus production **** 2. To inhibit mucus production 3. To neutralize acid production 4. To stimulate hydrogen ion diffusion back into the mucosa The pain of a duodenal ulcer can be distinguished from that of a gastric ulcer by which of the following characteristics? 1. Pain on empty stomach **** 2. Early satiety 3. Dull upper epigastric pain 4. Pain on eating While caring for a client with peptic ulcer disease, the client reports that he has been nauseated most of the day and is now feeling lightheaded and dizzy. Based upon these findings, which nursing actions would be most appropriate for the nurse to take? Select all that apply. 1. Reassessing the client on an hour 2. Administering an antacid hourly until nausea subsides. 3. Monitoring the client’s vital signs **** 4. Notifying the physician of the client’s symptoms **** 5. Initiating oxygen therapy Which of the following factors should be the main focus of nursing management for a client hospitalized for cholecystitis? 1. Assessment for complications **** 2. Administration of antibiotics 3. Preparation for surgery 4. Preparation for lithotripsy A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of the following assessments made after the procedure would indicate the development of a potential complication? 1. The client displays signs of sedation 2. The client demonstrates a lack of appetite 3. The client experiences a sudden increase in temperature **** 4. The client complains of a sore throat Which of the following tests is most commonly used to diagnose cholecystitis? 1. Abdominal CT scan 2. Endoscopy 3. Abdominal ultrasound**** 4. Barium swallow NCLEX Exam: Gastrointestinal Disorders (Sections 3. Vitamin C 4. Vitamin E Which of the following tasks should be included in the immediate postoperative management of a client who has undergone gastric resection? ✖ 1. Providing nutritional support 2. Assessing for bowel sounds 3. Monitoring gastric pH to detect complications 4. Monitoring for symptoms of hemorrhage **** After a subtotal gastrectomy, care of the client’s nasogastric tube and drainage system should include which of the following nursing interventions? ✖ 1. Irrigate the tube with 30 ml of sterile water every hour, if needed 2. Turn the machine to high suction of the drainage is sluggish on low suction 3. Monitor the client for N/V, and abdominal distention **** 4. Reposition the tube if it is not draining well The hospitalized client with GERD is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions? ✖ 1. On the left side with the head of the bed elevated 30 degrees **** 2. Supine with the head of the bed flat 3. On the right side with the head of the bed elevated 30 degrees 4. On the stomach with the head flat A female client complains of gnawing epigastric pain for a few hours after meals. At times, when the pain is severe, vomiting occurs. Specific tests are indicated to rule out: ✖ 1. Cancer of the stomach 2. Peptic ulcer disease**** 3. Pylorospasm 4. Chronic gastritis If a gastric acid perforates, which of the following actions should not be included in the immediate management of the client? ✖ 1. Fluid and electrolyte replacement 2. Blood replacement 3. Nasogastric tube suction 4. Antacid administration **** The client with peptic ulcer disease is scheduled for a pyloroplasty. The client asks the nurse about the procedure. The nurse plans to respond knowing that a pyloroplasty involves: ✖ 1. Cutting the vagus nerve 2. An incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum **** 3. Removal of the ulcer and a large portion of the cells that produce hydrochloric acid 4. Removing the distal portion of the stomach Risk factors for the development of hiatal hernias are those that lead to increased abdominal pressure. Which of the following complications can cause increased abdominal pressure? ✖ 1. Intestinal obstruction 2. Volvulus 3. Obesity **** 4. Constipation A client with a peptic ulcer is scheduled for a vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure: ✖ 1. Decreases food absorption in the stomach 2. Heals the gastric mucosa 3. Halts stress reactions 4. Reduces the stimulus to acid secretions **** A client is to take one daily dose of ranitidine (Zantac) at home to treat her peptic ulcer. The nurse knows that the client understands proper drug administration of ranitidine when she says that she will take the drug at which of the following times? ✖ 1. Before meals 2. When pain occurs 3. With meals 4. At bedtime**** The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy? ✔ **** 1. “Antacids will coat my stomach.” 2. “Sucralfate (Carafate) will change the fluid in my stomach.” 3. “Omeprazole (Prilosec) will coat the ulcer and help it heal.” 4. “The cimetidine (Tagamet) will cause me to produce less stomach acid.” – Given ******** The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750ml of green-brown drainage. Which nursing intervention is most appropriate? ✖ 1. Notify the physician 2. Clamp the T-tube 3. Irrigate the T-tube 4. Document the findings **** The client with GERD complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions? ✖